1 24 Russell Sa^e ;fowMd3+|o>, D^p^of ci,j/j ^^.e***.. 

Copy ^ 




FOURTH OF JULY INJURIES 
AND TETANUS 



THE SEVENTH ANNUAL COMPILATION BY 

THE JOURNAL OF THE AMERICAN 

MEDICAL ASSOCIATION 



A PLEA FOR A SAFE AND SANE FOURTH 



Reprinted, luith additions, from The Jotirnal of the American Medical 
Association, September 18, 1909, Vol. LIU, pp. 948-956 



copxright. 1909 

American Medical Association 

Five Hundred and Thirty-five Dearborn Avenue 

CHICAGO 



Pu"biiah3ff 

SEP 3c isn 






FOUETH OF JULY IKJUEIES AND 

TETANUS 



[EDITOEIAL] 
THE ANNUAL FOURTH OF JULY EECORD . 

In this issue of The Journal appears the seventh 
annual compilation of deaths and injuries resulting 
from the celebration of the Fourth of July. The fact 
that the celebration was spread over three da3^s this 
year, since the Fourth came on Sunday, may be partly 
responsible for the increased number of tetanus cases, 
the total being nearly double that of last year. Except 
in a few progressive cities which passed prohibitory or 
restrictive ordinances, however, there seems to have been 
a relaxation of authority regarding the use of fireworks, 
chiefly in Illinois, Massachusetts, New Jersey, New 
York and Peimsylvania. More serious has been the ab- 
sence or non-enforcement of restrictions on the use of 
blank cartridges, which, of course, accounts for the 
increase of tetanus cases. 

Tetanus antitoxin, although extensively used, was 
still not employed as much as it should have been, 
either as a preventive measure or after active symptoms 
began. In several instances, according to report, doctors 
still resorted to the old methods of treatment long 
known to be of little value. Several instances were 
reported also in which doctors did not lay open the 
wounds until after tetanus had developed, and, there- 
fore, too late to be effective. In some instances the later 
operation revealed imbedded in the wound the wad 
which should have been removed at the first treatment. 
The following simple rules have already had wide cir- 
culation, but should be carefully followed in the treat- 
ment of every blank cartridge or puncture wound : 



TO PREVENT LOCKJAW 

1. Freely incise every wound. 

2. Carefully and thoroughly remove from the wound 
every particle of foreign matter. 

3. Cauterize the wound thoroughly with a 25 per 
cent, solution of phenol (carbolic acid) in glycerin or 
alcohol. 

4. Apply a loose wet boric acid pack. 

5. Inject subcutaneously 1500 units of antitetanic 
serum. 

6. In no case should the wound be closed. It should 
be allowed to heal by granulation. The dressing and 
packing should be removed every day. 

Although the numbers of dead and of injured are 
larger than or as large as last year, there is, neverthe- 
less, abundant evidence of an increasing public senti- 
ment in favor of more rational methods of celebration. 
Two more cities, Washington and Cleveland, passed and 
enforced prohibitory ordinances, and Chicago enforced 
a restrictive ordinance, with the result that no casualties 
were reported for Washington, only four slight injuries 
for Cleveland, and less than half the usual number of 
accidents and no deaths for Chicago. These results 
show that prohibitive measures are more effective than 
mere restrictive ordinances, although restrictive meas- 
ures are much better than doing nothing. 

Efforts to provide safe amusements have been more 
extensive this year than ever before. Worthy of special 
mention is the plan adopted by Springfield, Mass., which 
shows the great opportunity offered by the annual cele- 
bration of the Fourth of July to instill in the minds of 
the youth of our land a spirit of genuine patriotism. 
The parades, the floats representing historical incidents, 
the picnics, and, last but not least, the annual chorus 
drill under skilled leaders in preparation for the mass 
singing of national airs and popular songs — all these 
methods, if more extensively employed, would add 
greatly to the value of the Fourth-of-July celebration in 
our national life, and help to do away with the present 
death-dealing methods of celebration. Those who are 
working toward better methods have reason for encour- 
agement and should persevere. City authorities should 
assist by prohibiting fireworks. The only objections 
seem to come from the ^T^usiness interests" involved. 
By the combination, therefore, of substitution and re- 
striction, a more enlightened celebration of our national 
Independence Day will be assured. 



STILL TEMPORIZING WITH THE BLANIv CARTRIDGE 
PISTOL 

Blank cartridge wounds canse more deaths in the 
annual celebration of the Fourth of July than all other 
factors combined. In seven years, 794 deaths have been 
caused by this one factor! Most of the victims were 
bright active boys, aged from 6 to 18 years, and they 
were doomed to die the most awful death known to 
medical science, a death the agony of which is probably 
not paralleled even by the tortures of the Inquisition. 
If this annual sacrifice were really necessary, it would 
be far more merciful to pick out the hundred or more 
youths each year and deliberately shoot them. But this 
annual outrage is not necessary; it is entirely prevent- 
able, and the prevention rests with our city govern- 
ments. 

For seven years The Journal has heralded these 
facts to the world. They have been given even wider 
publicity by some of our public-spirited newspapers. 
During the past two or three years the public press gen- 
erally has taken up the cry, and now no one can plead 
ignorance of the awful facts. Nevertheless, the average 
city government still views with the blind eye of callous 
indifference the fatalities for which it is morally re- 
sponsible. Some cities have, indeed, passed prohibitory 
ordinances, but have not enforced them vigorously. To 
permit the use of blank cartridges and blank cartridge 
pistols in the celebration of the Fourth of July is abso- 
lutely criminal. The city council which fails to pass 
and to enforce ordinances prohibiting the use of these 
instruments of torture will hereafter be open to the 
charge of criminal negligence. The plea of ignorance is 
no longer good; to temporize further regarding the sale 
and use of blank cartridges and blank cartridge pistols 
is to aid and abet torture and murder. 

These are strong words; but to use mild ones would 
be to trifle with the anguish and horror in scores of 
homes — a horror and anguish but faintly reflected in 
the appalling statistics on the subject. The only effec- 
tive way to deal with the murderous blank cartridge 
pistol is to pass and to enforce an absolutely prohibitive 
ordinance in each city. ISTo more temporizing should be 
tolerated. The agonizing deaths from this cause should 
cease. 



THE VALUE OF TETANUS ANTITOXIN 

Among the reports of the cases of tetanus that we 
have received we have frequently found the statement 
that tetanus antitoxin was not used because "the doctor 
said" that it "was useless," or "of doubtful value/' or "in 
an experimental stage." Therefore, although we have 
been to some pains at several times to set forth the exact 
status of tetanus antitoxin according to the best avail- 
able evidence, it would seem worth while again to dis- 
cuss the subject while it is so acutely before us as it now 
is. To put the matter in a nutshell, it may be stated 
dogmatically that the value of tetanus antitoxin as a 
prophylactic agent is very great, and its efl&ciency nearly 
absolute; as a curative agent it is by no means worth- 
less, and undoubtedly it saves not a few lives when 
properly used. Apparently, to judge from the reports 
at hand, many physicians have not yet learned to dis- 
tinguish between the results obtained by the prophylac- 
tic use and by the curative use of tetanus antitoxin; 
the usual futility of the latter has been incorrectly as- 
sumed to apply to the former. 

The example of using tetanus antitoxin for preventive 
purposes was first furnished by the veterinarians, who 
have to contend with tetanus much more commonly 
than we. Knowing that in certain stables the horses 
which received wounds were very likely to develop teta- 
nus, they found it desirable to try to prevent this seri- 
ous complication by injecting antitoxin into all horses 
that had received wounds. The results that they ob- 
tained were from the first so striking that now antitoxin 
prophylaxis is invariably used to prevent endemic and 
epidemic outbreaks of tetanus in horses. For example, 
in one stable in which from six to eight cases of tetanus 
developed yearly, it was decided to give every horse with 
wounds about the feet a prophylactic dose of antitoxin; 
during the following five years three hundred horses 
were so treated without a single case of tetanus, al- 
though one horse which received no antitoxin developed 
the disease.^ Vaillard^ says that in a series of 13,124 
prophylactic injections in horses not one contracted, 
tetanus. In man it is not so "easy to estimate the results 
of tetanus prophylaxis, for, outside of Fourth-of-July 
tetanus, we do not often get a chance to observe this 

1. Wells, H. G. : Medical News, June 1, 1901. 

2. Bull. Acad. M6d., Paris, 1908, Ixxii, 581. 



disease in epidemic proportions, but such evidence as 
we have is almost equally favorable. Suter^ has col- 
lected 700 cases in which but one light attack of tetanus 
was observed among all the patients given antitoxin. In 
France, where this practice seems to have been especially 
general, there have been a few cases of tetanus in spite 
of prophylactic injection, but the entire evidence is 
emphatically in favor of the value of this procedure; 
indeed, Vaillard claims that in only five cases m the 
literature to 1908 can the antitoxin prophylaxis be con- 
sidered a complete failure. The Society of Surgery of 
Paris recently reported that in a group of Pans hos- 
pitals there had occurred in the last seven years but 
eleven cases of tetanus, all of which were m persons 
who by some mischance had not received the customary 
preventive dose of antitetanus serum, which is the rou- 
tine practice there after a street accident. Kocher went 
so far as to say before the German Surgical Society that 
he would consider any physician entitled to reproof who 
failed to use this measure in a case of injury with con- 
tamination of the wound by street dirt. 

In this country, the prophylactic treatment of 
Fourth-of-July injuries has been, so far as we can 
learn, invariably successful, and our annual mortality 
list from "patriotic" tetanus has occurred because of 
the lack of this measure in the cases of the victims. It 
is to be expected that a few cases may occur in spite of 
antitoxin, especially when it is given several days after 
the injury is received, because by this time the disease 
may be well advanced and the blood loaded with tetanus 
toxins, even several days before the appearance of 
symptoms.* But even in these cases the prognosis will 
be much better if the antitoxin is given before rather 
than after the symptoms have developed. 

To neglect to use antitoxin as a curative agent is also 
unwarranted in the light of our present knowledge, even 
although the results are by no means so striking as with 
diphtheria antitoxin. There is no question that more 
of these patients recover with antitoxin than without, 
even if the number is not great. Especially efficacious 
seems to be the intraspinal route of administration, for 
by this means the antitoxin is brought into close contact 

3. Arch. klin. Chir., 1904, Ixxv, 113; Beltr. klin. Cbir., 1907, 
"' 4.'Madsen: Centralbl. f. Bakteriol., 1908, xl. No. 3. 



8 

■with, the place where it is most needed, and it is well 
known that antibodies injected subcutaneously or into 
the blood directly do not find their way into the cerebro- 
spinal fluid in large amounts. Clinical results support 
this theorization, and Hoffmann^ reports a series of 
thirteen eases with 58 per cent, mortality in which the 
antitoxin was given subcutaneously, whereas of sixteen 
patients given intradural injections only two died, and 
these from complications. Undoubtedly some of the 
earlier disappointments witli antitoxin prophylaxis and 
treatment were the result of the uncertain activity of 
the antitoxin preparations then on the market, a defect 
which has been remedied in this country by the system 
of standardization developed by the Hj^gienic Labora- 
tory of the Public Health and Marine-Hospital Service. 



[THE REPOET] 

SEVENTH ANNUAL SUMMAEY OP POUETH OP 
JULY INJUEIES 

Por the seventh consecutive year we are presenting 
statistics of injuries received during the celebration of 
the Pourth of July, with particular reference to tetanus 
resulting from these injuries. Considerable effort has 
been made to secure reliable data, and all serious cases 
have been carefully investigated, so that, so far as the 
figures go, dependence may be placed on them. We have 
received thousands of letters from physicians in all parts 
of the country, reporting cases which otherwise could 
not have been included in the statistics. There are doubt- 
less thousands of other cases not reported, although 
chiefly minor injuries. Our thanks are due for the many 
careful reports which have made these statistics more 
complete and the figures more reliable. The data are 
presented in the same manner as heretofore, in order 
that comparison may be made. 

MORE CASES OP TETANUS 

There were 150 tetanus eases this year, almost double 
the record of last year, when 76 cases were reported. 
This is the largest number since 1903, when there were 
415 cases. It is significant to note that the number of 
blank cartridge wounds correspondingly increased from 

5. Beitr. klin. Chir., 1907, Iv. 



Table 1. — Cases of Tetanus 



Name. 



Sex. 



Benbow M 

Gardner M 

Corbin M 

Smith M 

Padgett M 

Hendricks. M 

Allen M 

Brown M 

Binaraman. M 

Cook M 

Ebright M 

Ford M 

German M 

Gestel M 

Granat M 

Haffey M 

Menson M 

Morris M 

Muelford M 

Neff M 

Qiiinn F 

Keed M 

Eemiliard M 

Simmons M 

Stoffel M 

Verbelia M 

Callahan ,M 

Czer winski M 

Dolson M 

Kennedy . , M 

Lacey M 

Lurok M 

McCoy M 

Thompson M 

Webster M 

Parks M 

Allen F 

Clark M 

Miller M 

"Van Meter M 

Williams M 

Yocum M 

Gill M 

Pitts , M 

Behrman M 

Cavey M 



Cause of 
Age. Wound. 


Site of 
Wound. 


'^ 03 

3 a 




CALIFORNIA 








16 Bl. ctg 

45 Firecracker. 


..Hand 

..Hand 


,. . 10 

,. . . 11 


D. 
D. 


DELAWARE 








13 Bl.ctg 

17 Bl.ctg 


. . Hand. . ' ' 
..Hand 


■•■(6) 8 

7 


D, 
D, 


FLORIDA 








12 Bl.ctg 


..Hand 




D, 



IDAHO 

27 Gunshot. 



.Ankle 10 D. 



11 Bl. 

14 Bl. 

8 Bl. 

13 Bl. 

14 Bl. 
11 Bl. 

8 Bl. 

13 Bl. 

10 Bl. 

15 Bl. 

9 Bl. 
Boy.Bl. 

11 Bl. 
19 Bl. 

14 Bl 
13 Bl. 
17 Bl. 

Boy.Bl. 

12 Bl. 
12 Bl. 



.Finger (4)13 D. 

~ " D. 

D. 
D. 
D. 



ctg.. 

ctg Hand 

ctg. Hand 

ctg Hand 

ctg 

ctg Hand 19 D 

ctg Hand 12 D 

ctg Hand 7 D. 

ctg Thigh (10)22 R. 

ctg Hand 30 E. 

ctg Finger 7 D. 

ctg Hand 

ctg Hand, (7) 9 D, 

ctg Hand 10 D. 

ctg Hand 25 K. 

ctg Hand 

ctg Hand 9 D. 

ctg Hand 13 D. 

ctg Thigh (7) 9 D. 

ctg Hand 15 D. 



INDIANA 
11 

12 
13 
12 
13 
15 



Bl.ctg Hand... 

Bl.ctg. 

Bl.ctg. Hand... 

Bl.ctg 

Bl.ctg Hand.,. 

Firecracker . . Thumb. 

Bl.ctg 

Bl.ctg Leg.. .. 

Bl.ctg Hand... 



is 


T) 


9 


1). 


7 


1), 


7 


1). 


7 


1). 


S 


1), 


20 


1). 


8 


D, 



IOWA 

11 Bl.ctg Hand. 



9 D. 



6 Bl.ctg 


....Hand 


. . . . 14 


D. 


16 Bl.ctg 


....Hand 


. .. 11 


i). 


16 Gunshot . . 


Knee 


7 


i). 


Boy.Bl. ctg 






I>, 


8 Bl.ctg 


Penis 


...(7)10 


D, 


9 Bl.ctg 


....Hand 


9 


D. 



KENTUCKY 

8 Bl.ctg Hand... 

MAINE 

13 Bl.ctg Hand,.. 

MARYLAND 

18 Bl.ctg Finger. 

14 Bl.ctg Hand... 



11 D. 



.(10)48 
14 



10 



S?Q 









Cause of 


Site of 


|3 d 


<D 


Name. 


Sex. 


Age. Wound. 


Wound 


P-" 




MASSACHUSETTS 








Blanchette. C 


M 


15 


Bl.ctg 


.Hand 


....(5)11 


D. 


Bouchard, A 


M 


14 


Bl.ctg 


.Hand 


.... 17 


D 


Brown 


F 


24 


Bl.ctg 


.Thigh.... 


...(15)20 


1). 


Joseph 


M 


20 


Bl.ctg 


. Hand . . . . 


....(6) 9 


1). 


Killeen 


M 


29 


Bl.ctg 


.Hand 


7 


D, 


Nagen 


M 


14 


Firecracker. . 


.Hand 


....(8)14 


U. 


Norton 


M 


11 


Bl.ctg 


. Hand.... 


....(7)50 


K. 


Silva 


M 


23 


Bl.ctg 


.Hand 


.... 15 


K. 






MICHIGAN 








Ashlund 


M 


12 


Bl.ctg 


.Hand 


9 


D. 


Barnett 


M 


13 


Bl.ctg 


.Hand 


....(7)12 


i>. 


Cole 


M 


10 


Bl.ctg 


.Hand 


7 


i>. 


Damm 


M 


1.5 


Firecracker. . 




.... 16 


i). 


-Lawler 


M 


11 


Bl.ctg 


.Hand 






McEorie 


M 


12 


Bl.ctg. 


.Hand 




D. 




M 

M 


13 
10 


Bl. ctg 




9 


1), 


Schaff 


Bl.ctg 


.Hand 


7 


D. 


Sheridan 


M 


12 


Bl.ctg 








Stewart 


M 


1.5 


Bl.ctg 


.Hand 




i). 


Straft'on 


M 


16 


Bl.ctg 


.Hand.... 


18 


D. 






MISSOUEI 








Adair 


M 


Boy. Powder expl 


..Arm 


.... 18 


T>. 


Cooper. 


M 


l(j 


Bl.ctg 


.Hand..... 


.... 10 


D. 


Enloe 


M 


13 


Bl.ctg 


.Hand 


9 


i), 


Hogan 


F 


2H 


Bl.ctg. 


.Hand 




i>. 


Judson 


M 


10 


Bl.ctg 


.Hand 


7 


D. 


Neland 


M 


10 


Bl.ctg 


.Hand 


...,(5)11 


D. 


Solomon 


M 


10 


Bl.ctg 


.Hand 


.... n 


u, 


Taylor 


M 


11 


Bl.ctg 


.Hand 


.... 11 


D 






MONTANA 








Kelly 


..-. ....M 


23 


Bl.ctg 


.Hand 


.... 10 


D. 


Mulholland 


M 


16 


Bl.ctg 


..Hand 




i). 


Staten 


M 


7 


Bl.ctg. 


.Hand 


.... 10 


D. 






NEBRASKA 








Dlargy 


M 


12 


Eocket 


Hand 




D. 


Pop 


M Adult.Bl.ctg 


.Hand 


.... 10 


i). 


Watkins 


M 


13 


Bl.ctg 


.Hand 


9 


U. 




NEW HAMPSHIRE 








Boyle 


M 

] 


17 

S'EW 


Bl.ctg 

JERSEY 


.Hand 


....(7) 9 


D, 


Campbell 


M 


12 


Bl.ctg 


.Hand..... 


....(6)14 


D. 


Da Costa 


M 




Gunshot 


.Finger. . . 


.... 10 


i). 


Fischer 


M 


14 
13 


Bl.ctg 

Cannon 


.Hand 

.Thigh.... 


7 
.... 10 


1). 


Francke 


M 


D. 


Frisco 


M 


13 


Fireworks 








Goldstein 


M 


8 


Bl.ctg 




9 


i). 


Guthrie 


M 


9 


Bl.ctg 


.Hand 


....(6) 8 


D. 


Hunt 


M 


U 


Bl.ctg 


.Hand 


8 


i). 


Jasperino 


M 


14 


Bl.ctg 


.Hand 


.... 18 


K. 


Keley 


M 


13 


Bl.ctg 


.Hand 


7 


i). 


Long 


M 


12 


Bl.ctg 


.Hand..... 


8 


D. 


Mclntyre 


M 


14 


Bl.ctg 


. Finger. . . . 


.... 10 


D. 




M 


14 


Firecracker., 
Bl.ctg 


..Hand 

.Hand 


:.■.■.■ (8)10 




Miner 


M 


D. 




M 


13 
12 


Bl.ctg 

Bl.ctg 


.Hand 

.Hand 


8 
....(8)11 


I), 


Eiccio 


M 


D. 


Walters 


M 


12 


Bl.ctg 


.Hand 


7 


i). 


Weigel 


M 


11 


Bl.ctg 


.Hand 


.... 30 


E. 


Wilson 


M 


12 


Bl.ctg 


.Hand 


...(12).. 


K, 



11 



Name. 



Sex. Age. 



Cause of 
Wound. 



Site of 
Wound. 



NEW YORK 



Brightman M 

Jeriorski M 

Last M 

Mafredonia M 

Ohlowald M 

Otis, M 

Schroeder M 

Schultz M 

Stanway M 

Tatar M 

Wiegland M 



Combow M 

Getroast M 

Lewe M 

Manuel M 

Marcum M 

Parkos M 

Seaman M 

Sells M 

Sliman M 

Stokely M 

Tindall M 

Underwood.. M 



14 
12 
11 
12 

12 
13 
13 
10 
15 
10 
14 



Bl.ctg Hand... 

Bl.ctg. Hand... 

Bl.ctg. Hand... 

Bl.ctg Hand... 

Bl.ctg Hand... 

Bl.ctg Hand... 

Bl.ctg Hand... 

Gunshot Thigh . . 

Bl.ctg Finger. 

Firecracker. ..Hand... 
Bl.ctg. Hand... 



Powder expl. .Hand.. . , 

Bl.ctg Hand... 

Bl.ctg Hand... 

Bl.ctg Hand ... 

Bl.ctg Hand ... 

Bl.ctg Finger.. 

Fireworks 

Bl.ctg Hand... 

Bl.ctg. Hand... 

Bl.ctg Hand 



Bl.ctg 12 



Boy. Bl.ctg Hand 



PENNSTLYANIA 



Breich M 

Coles :M 

Donovan M 

Farber M 

Houpt M 

Koslovski M 

Kowalick M 

Maxwell M 

Scott M 

Werts M 



16 
15 
13 
18 
15 
11 
6 
13 



Bl.ctg Hand 

Bl. ctg Leg.. 

Bl.ctg 15 



Bl. ctg Finger. 

Bl.ctg Groin. . 

Bl.ctg Hand.. 

Bl.ctg Hand.. 

Bl. ctg Finger. 

Boy. Firecracker . . . Leg 

13 Bl.ctg Finger. 



o >, 




"42 c8 


;^ 


cap 


3 


S 


o 


Q-^ 


K 


12 


D. 


20 


1). 


7 


1). 




1). 


9 


D. 


6 


D. 


11 


1). 


(7) 9 


1). 


14 


I). 


(8)10 


D. 




U. 


16 


E. 


10 


1). 


(7)10 


i). 


8 


1). 




1). 


(5)14 


D. 


18 


1). 


10 


1). 




1). 


9 


1). 


12 


1). 


16 


D. 


8 


D. 


6 


i). 


15 


1). 


22 


D. 


6 


[). 


11 


D. 



12 D. 

10 i). 



Phebus. 



SOUTH DAKOTA 
kI 11 Bl.ctg... 



. Finger . 



WASHINGTON 



Brown M 11 

Nelson M 13 

Perry M 14 

Roth M 10 



Bl.ctg Hand 

Bl.ctg Hand 

Bl.ctg Hand 

Bl.ctg Hand 



7 D. 
"6 D. 



WEST VIRGINIA 



Comedy M 13 

Llewellyn M 9 

Parshall F 15 

Robinson M 10 



Bl.ctg Hand , 

Bl.ctg Hand , 

Firecracker. ..Hand 
Bl.ctg Hand , 



16 



6 D. 



WISCONSIN 



Briscoe M 

Darling M 

Dakonich M 

Golden M 

Micka M 

Peterson M 

Rhein F 

Kutz F 

Zettman M 



12 Bl.ctg Finger (6) 8 

11 Bl.ctg Hand 11 

15 Bl.ctg Hand 9 

11 Bl.ctg Hand 8 

13 Firecracker . . . Hand (8)13 

16 Bl.ctg Hand 8 

11 Bl.ctg Hand 9 

30 Bl.ctg... 8 

. . Powder expl 1 



Figures in parentheses show incubation period. 



12 



816 last year to 1,095 this year, and that the states hav- 
ing the largest numbers of blank cartridge injuries have 
also the largest numbers of tetanus cases (Table 5). It 
is interesting also to state that from blank cartridge 



TABLE 2. — Comparison with Previous Years 



1903 1904 1905 1906 1907 1908 1909 



Alabama . . . 
Arizona .... 
California . . 
Colorado . . . 
Connecticut 
Delaware . . . 
Dist. Colujpb 
Florida 
Georgia 
Idaho . 
Illinois 
Indiana 
Iowa . 
Kansas 
Kentucky . 
Louisiana 
Maine . . . 
Maryland 
Massachusetts, 
Michigan 
Minnesota 
Missouri 
Montana 
Nebraska 
New Hampshir 
New Jersey . 
New York . . 
North Dakoti 

Ohio 

Oklahoma . . 
Oregon .... 
Pennsylvania. 
Rhode Island 
South Carolina 
South Dakota 
Tennessee . . 

Texas 

Utah 

Vermont . . . 
Washington 
West Virginia 
Wisconsin 
Wyoming 

Total . . 

States having 
cases .... 



1 
49 
11 
14 
11 

4 

2 

1 

16 

29 

15 

29 

2 

4 

e 2 

8 

36 

I 

67 

1 

2 

82 

3 



3 
10 



415 



15 
6 
2 
1 



17 



105 



20 
3 
3 



1 

12 



13 



104 



16 

8 
4 

1 

1 
1 
3 
4 
2 
3 

1 
1 

10 

8 

7 
1 
1 



89 



12 



73 



12 

1 
1 

1 



10 
9 



76 



2 

1 

1 

20 

9 

1 



11 



3 
3 
1 

19 
11 

12 



10 



30 



21 



23 



25 



23 



20 



150 
25 



wounds there was a higher percentage of deaths (10.3) 
than from gunshot wounds (6.1 per cent.). 

The most common cause of the wound is the blank 
cartridge, and the usual site is the hand. The duration 



13 

given is the number of days between the injury and death 
or recovery. Following the injury it required from 5 to 
15 days before the symptoms of tetanus appeared, the 
average of all fatal cases being about 7 days. The longer 
incubation period doubtless indicates a less virulent 
germ and, therefore, a better chance for recovery by 
treatment. In one case the symptoms began on the 
fourth day, while in another case they appeared on the 
fifteenth. Following the appearance of the symptoms 
death resulted in from 2 to 9 days, the average of all 
cases reported this year being about 3i/2 days. In 4 cases 
the entire duration of time between inoculation and 
death was six days or less. The average duration for all 
fatal cases reported was IOI/2 days. The list of tetanus 
cases is given in Table 1. 

TABLE 3. — Causes of Tetanus Cases. 

Blank Giant Can- Fire- Powder, 

Year. Cartridge. Cracker, non. arms. etc. Total 

1903 363 17 5 3 27 415 

1904 74 18 5 1 7 105 

1905 65 17 4 5 13 104 

1906 54 17 1 7 10 89 

1907 52 8 6 4 3 73 

1908 58 5 4 3 6 76 

1909 130 9 1 4 6 150 

TABLE 4. — Causes of Deaths Aside From Tetanus 







Fire 


Powder, 














from 


Tor- 












Gun- 


Fire- 


pedoes, 


Giant 


Can- 


Other 




Year. 


shot. 


works. 


etc. 


Crackers. 


non. 


Causes. 


Total 


1905.. 


. 37 


23 


6 


5 


7 


17 


95 


1906.. 


. 38 


18 


18 


3 


3 


3 


83 


1907. . 


. 20 


31 


13 


13 


3 


22 


102 


1908.. 


. 30 


22 


19 


23 


7 


~7 


108 


1909.. 


. 17 


37 


16 


7 


7 


6 


90 



Tetanus cases occurred in 25 different states, or in 5 
more than last year, and the same as in 1906. For the 
fifth consecutive year Illinois reports the largest num- 
ber, having 20 cases this year, 12 each in 1908 and 1907, 
16 in 1906 and 20 in 1905. In 1903 and 1904 Pennsyl- 
vania reported the highest numbers. For the fourth 
consecutive year ISTew Jersey reports the next highest 
number, having 19 cases this year, 10 last year, 8 in 
1907 and 10 in 1906. Ohio reports 12 cases this year. 
Michigan and N'ew York each had 11 cases and Penn- 
sylvania 10. Table 2 gives a comparison of the number 
of cases in each state for the seven years. 



•SJiaoAi 
-ejg puB aapA\o<j 



iH • C-l 00 OJ •* 



•sniiBaji,a 



H CO 1-1 <M 



•uonuBO 



■SJa3IDB.lDa.TTiI iH 



CO oj 



eS2 " 



•aSpi.T;.TBD JinBia ; ; i;::^'^^ : : : : ;Sm'^m • ;=^''~'J3"*^ ;E 

■sasiiBD jaiHO nv i.'i'^ !!'!!!'"'!'"';'"'! I! !'"''"';:'" 
•a§pu:j.TBD 5iaBia ; ; ;^ ■ ;|^^ •'-' • -ooor-iiOrH •.-^l^^^-o 



•pajiiCuT .TO 
pBap snosjad iB;oi 



•saunC 
-ui IB jBj-noa iBioi 



■saT.TnCni aamo 



B! •a.Tota .TO 

.g eno 'sjaSng jo ssoq 



•SpnBTl JO 

stn.TB 'sSai JO sso^ 



•ajfa ano jo ssoq; 



C] 



(Nt-eOi-lCOt- -(MOOt-CO •?! 
rt<COCDO0'-l '(Mi-ICOt-O -O 
IC 1-1 ■* T-l CO 



C5<NOOCO -iHClTtlCOCO •(» 
iMlOCSOOrH -(M iHOCS -CO 

lO rH ^ rH CO 



-tiCOCOOSlO .OOSTtfCOW •» 
OTfOOI>rH -IN 05'*© .CO 

\a i-i CO 1-1 CO 



■<*l (M CI iH 



T-l • CO 00 



•jqSjs JO ssoi • . . . • (N 



•smBap ib;ox 



CO 1-1 CO CO 



i-l 00 rH T-l CO rH 



CO ■* CO • ■* 



•sasnBD jaTjijo moj^ 



iH iH CO iH 



rH la CO -CO 



•snuBjaj THOj^ : ; : '^ \ ; '^^ ; : irHj^orHco 



rH rH » C5 






25 § o «-r; 

*w ri \r*. rn rn _ 



o fl p -3 ?i 5 



<\ <i -Hi 






§S 



05 -TfO •■* -COlO -t-IOOCONCIiHOt-i-^-^IOCO 
,-1 CO lO 



O OO 00 iM K5 CO iH 

CO LO iM (N t- JO CO 

CO 0_ lO OD C0_ O t- 

r4 w" rH i-T i-T i-T 



VO CO • tH 



iH r-l (M (M tH CD CO 
■* CO O CO O O CO 

CO ■* in lO ■* Tji iM 



iH CO • CO C5 ■* 



t^ OJ b- CO ■* 00 t~ 
Cq O CO O b- O Oi 
Tf CO C^ 'S' ■* lO CO 



CA a • t- 



051-lOOOCO-HNrH -OCO -l-t-O 



■* CO CJ O lO 00 W 

iH 02 CO CJ t- CO lO 
CO t- '♦t CO t~ iM T-l 



•^ a • CO CO rH Ol 
M CO 



0:J tH tH (N Ttf 



to CO TJH lO '^ r-( Ol 
O T-l LO (N ■* CO O 
O 00 lO 03 t- O CO 



t- CO CO CO CO CJ 03 

O 04 tH CO I— CO -* 

CO CO T« T}< rH rH '^f 

lo lo ^ in lo -* Tj!" 



■*0(NrHCi03^00Tj<rtlCOC-lCOC30'*TH 
THrHINinCO T-Irt OlM^ 



I CO O 03 CO tH CO CO 

I O CO Tf O C3 CO CO 

O ^ N CO 03 Ol 03 

I in in" ■* in Tj^" CO co' 



■* •TP(NiHr-(CO0C-*00->*-*COlMC0COb-(MT-l 
<N' O5r-IINOCO t-HtH 0)(M-* 



CO m 00 th 0-1 t^ o 

(M iH CO CO CO CO l> 
00 rH 00 03_ in CO CO 

Tti' in CO •* ■* CO CO 



CO ^ l- t- iH CO ■* 
I- OO 05 C-l C^I O t- 
iH tH IN (M N IM 1-1 



CO rH -CO 



t- CO • T-i 



• o\ • th CO in CO 



(M rH iH 1-1 iH 









B ^ ^ !>^ 



• a c« 
cs 'a 3 -t; 

^ I— ( cd <^ *!> 

^,5oQ Si 



a>ajiue)aJ<i)Ooa4!jfc(a).3ooa)a>±^ 



a -5 



a 


> 


CO 

a 


■d 


-i-> 


o 




rn 






<D 




p:^^ 



ux Tfi xn xfi m m m 
^ c^ ^ ^ ^ ^ ^ 
o o o o o o o 



05 CO !>• CD »0 ''^ CO 

o o o o o o o 

02 0^0^0^0^ 



^ Gi C3 Oi Os Oj 

!> iH iH 1-i tH r-l 



16 

Blank cartridges still continue to be responsible for 
the great majority of tetanus cases, 130, or 86.5 per 
cent, of all cases this year, being due to that cause^ as 
compared with 73.3 per cent, last year and 71 per cent. 
in 1907 and 60 per cent, in 1906. Nine cases this 5^ear 
resulted from giant firecracker injuries, 4 cases from 
gunshot wounds, 1 case from toy cannon injury and 6 
from other forms of fireworks. 

Of the 150 cases of tetanus due to Fourth of July in- 
juries this year, 125, or 84 per cent., were reported to 
have ended fatall}^, as compared with 72 per cent, of 
deaths last year, 85 per cent, in 1907 and 84 per cent, 
in 1906. 

TETANUS FROM OTHER THAN" FOURTH OF JULY INJURIES 

Besides the cases of lockjaw due directly to Fourth of 
July injuries, many other cases were reported this year 
which occurred during the Fourth of July season, but 
which were due to penetrating injuries from nails or 
splinters, to crushing injuries or other causes. There 
were 128 such cases reported this year, as compared 
with 166 last year and 94 in 1907. The report of these 
cases emphasizes the fact that in the treatment of all 
penetrating wounds the possibility of tetanus should be 
borne in mind and prophylactic measures employed. 

■Of the 128 cases of tetanus due to other than Fourth 
of July injuries, Pennsylvania reported 21, Illinois 18, 
Ohio 13 and New York 12. Altogether 25 states re- 
ported cases, as compared with 28 last year. Table 8 on 
page 953 shows these cases by states and will be inter- 
esting in comparison with Table 2. 

DEATHS FROM FIREV^^ORKS^ ASIDE FROM TETANUS 

Besides the 125 deaths due to tetanus, 90 persons were 
killed by various forms of fireworks, making a total of 
215 deaths, an increase of 52 over last year and 57 more 
than in 1906. Seventeen were killed outright this year by 
firearms, 16 were killed by explosions of powder, 7 by 
giant firecrackers, 7 by toy cannon and 7 by various 
causes, such as blood poisoning, by sky-rockets, chemi- 
cals, etc., while 37 were literally burned to death by fire 
from fireworks, many of which were caused by the so- 
called "harmless" varieties of fireworks. As heretofore, 



17 

all accidents not directly due to the discharge or han- 
dling of fireworks or other means of noise production on 

or about the Fourth of July have been omitted. Table 4 

TABLE 6. — Total Deaths axd Accidents bt States Dcrixg 

Seven- Yeahs 

1903 1904 1905 1906 1907 1908 1909 

Alabama 2 7 1 2 1 i i 

Arizona 1 .. 4 5 o 5 3 

Arkansas . . 3 4 . . 5 1 

California 100 138 142 96 121 136 89 

Colorado 39 44 26 23 25 13 18 

Connecticut . . . 162 133 132 169 63 105 86 

Delaware 1 5 14 8 16 12 13 

Dist. Columbia. 2 10 24 5 12 21 

Florida 1 2 2 .. .. ~. { 

Georgia .. .. 4 2 4 

Idaho 4 4 3 3 4 4 2 

Illinois 366 423 542 598 468 558 546 

Indiana 160 211 217 250 . . 255 164 

Iowa 168 137 328 255 231 174 91 

Kansas 63 88 56 61 64 72 86 

Kentucky 30 72 17 21 18 33 17 

Louisiana 2 3 7 8 4 

Maine 31 32 29 15 11 16 22 

Maryland 21 22 13 10 23 21 10 

Massachusetts.. 637 193 467 329 168 430 430 

Michigan 144 157 288 193 163 203 177 

Minnesota 157 102 174 95 9." 65 69 

Mississippi .. .. 2 2 1 

Missouri 147 84 218 325 299 375 352 

Montana 5 17 40 3 6 11 9 

Nebraska 46 63 43 47 58 46 42 

Nevada 1 2 .. 1 4 

New Hampshire 37 23 9 29 13 13 23 

New Jersey . . . 228 204 350 398 402 472 488 

New Mexico 4 5 1 6 .. 1 

New York 522 549 566 681 752 647 897 

North Carolina . . . . 1 1 

North Dakota.. 10 8 29 11 8 13 4 

Ohio 443 327 329 490 375 543 323 

Oklahoma 1 3 7 14 194 9 12 

Oregon 16 13 9 11 5 9 21 

Pennsylvania .. 533 744 721 969 491 987 986 

Rhode Island.. 64 30 11 21 39 39 42 

South Carolina . . . . . . 1 . . . . 4 

South Dakota. . 4 10 15 5 8 10 9 

Tennessee 4 1 5 6 4 5 4 

Texas 2 2 4 11 7 11 4 

Utah 23 22 25 18 30 12 18 

Vermont 45 14 10 14 18 19 12 

Virginia 11 5 8 .. 5 4 

Washington ... 21 25 15 25 23 38 32 

West Virginia.. 19 16 34 64 27 29 35 

Wisconsin 190 215 230 155 150 187 157 

Wyoming 1 2 8 3 .. 1 1 



shows a comparison of the causes of death other than 
from tetanus for the past five years. 

In Table 5 will be found a summary of all injuries, 
including tetanus, and of all causes, arranged by states. 



_: t-i-l N iH CO C50 N QDOONl-T-INOiOl-OJMOT-ITtft-OOOCOO • 00 00 (N t- 1- tH 00 lO rH iH t- Tt< rH 
S Ol t-00 OOiH tH CD 05 50 01 OOO-^lrHCOCD-^t-eOOOlOlOlNOiHCOtO -CO lO tH ■* lO OO O (M 05 rHO 



000<NiH-*tH10COIO 
■* (M <M iH 1-1 rH 1-1 



3 lO T-l lO rH r-l 



•Tt<HCOHCO -rH •lOfO -CO •■<*< • tH • -(NOSTtl . .r^-rjl 



<U t- • C5 ■* lO • • • lO -(NfO 

3 



•Ti'<(M -iH -H •!-( 



a) CO (M CO C: O O CO r-l O tH 0(MOTf(THr-lOTHO-*COT-IOlOOOCC10 •OCOO •■* t-iH rHCOe<ieOTHO 
;: iHONC-105rH02rH05rHHi-lt- IMOOHCOrHrHrH(MT-llO T-i -W iH •i-IH-<t(eo rH ■* 

.S CO C^ 't Ca iH rH 



OJ i-I(MCO-*COt-((NCO 
^ iH iH rH 



•IM -lO •'-I -rH 



.H. ■* rH (M 1 



'C IM CO I- CO CO 



•rHrH -lO -rH 




pS ■ COiaiOOOOOil 

OljCO TtiOOCOWt-CD( 

:j3 so OrHt-C0lMC0< 

^W2 M CSrHOTiOreO OrH lO TfTcoiOt 

■g O! rH ^Tj< Tt< OlO COQO t- CO 10Tt<r-irnwuui 

e, p _^ rH 0_-* CO CO LO ■* CO CO CO COCOCOCOCOIMC 

O 5? !» 'di" W rn" 

o ::::::::::::::::::::::::::::::::::::::::: 

■T-S S s^ ca'M s-S " 8 325*9 

35^gag&S2^^t:s«s» 

^;oa^MMMOCq^wPu§^5^aSl^l-^M!»P^MWE^QU<5^So2;!aMwPH^fa<3^aJ 




•(Nt-M0SlOC0rHlMlMl-lOC0K5N -OO-* I COt- I O 
rH rH Win 00 



• 10 tH rH • Ol (N -CD 



t-io 

lOOO 



•»J<M • rH i-H 00 t-rHOOO^ •iHCOOOCO •CDCIOONt 



com 03 

05tH O 



•(M • -rH .tH 



oio I in 

ooeo r-i 

1-1 IM 



■CO -l-COOi 



)rHi-l -t-hCO 



OO 

do 



to 


•rHCOCOCONlO 


• co^ooin • • 


• -CO-* CI 


1 COi-l 


rH 


i-l CO 


•rfH rH • • 


• -(M 


■* t- 



C5 ■* Tt< t- (N CO r-l «0 >0 O CD CO rj( 00 CO (N to CO «0 IM 00 00 CO t- T-l 02 in CD CO O t- 1-H in 0> CO IM iH CO <N t- lO iM t- 
0505T(<COOOt--^-*in-*-*Ot-TlH(MrHTt(rHCOr-|-*050>COCOODCD050r-linrHOOrHOOiMCSiCOTHC003CO 
t-^t-^in in 00 iH_iH (N CO »H OO >> Cl t-^CO Ol t-^in OO OO W t> in CO 05 to COOt-rHOlt-i-ICiaJClT-fOSrHCOt-eOrH 

©croo"odininTHb^coinT^rtrri?'odoo"t>?o«oincor-rooot^«3 

OC5001CJ05050000GCOOOOCOt-t-t-t-t-t-t-t-t-CO«5!OCD«550'fflCO«>Q5COCOCOW?OininiGininin 






,*!> 






.60 c 









•S a-^ SS <um B'^ a'O rt Mrt"^ m ^-a« 



g5a^2 3«>S& 



O SH.M g 



a >7" ji-so 

o oj " o o a> 



eS o M 
i+J^ o 



M 

CD 



Z o-£?Ph 
: .on 



M-«5 



? 






, MCCCh m tu 
g MJ3 ei 1=1 



HM^M&BIUalllEHPH 



& \2 



05 »2 

"3 '3 



02 rQ 



30 

Beneath the totals at the bottom of the table are given 
the totals for the six previous 5'ears in order that com- 
parisons may be made. The grand totals are also given. 
Table 6 is arranged to show a more ready comparison 
by states of the total deaths and accidents for the six 
years. 

Pennsylvania holds the blackest record with 986 
casualties, Kew York coming second with 898, followed 
by Illinois with 547, New Jersey with 488 and Massa- 
chusetts with 430. Altogether there were 5,307 accidents 
this year, or 316 less than last 5^ear. 

NON-FATAL INJURIES 

There were 5,093 non-fatal injuries this year, 
or 368 less than last year. There were 16 people 
totally blinded this year, being 5 more than last year, 
but 9 less than the highest number in 1905. There were 
36 who lost one eye each, 41 who lost legs, arms or 
hands, while 176 persons lost one or more fingers. The 
giant firecracker holds the first rank as a cause of mutil- 
ating wounds and is responsible for the majority of 
losses of eyes, hands and fingers during the annual cele- 
bration of the Fourth. In the awfulness of its destruc- 
tion, the giant firecracker is equaled in a few instances 
only by the explosions of home-made cannon. The fact 
that the wounds made by the giant firecracker are so 
lacerated and laid open is probably the reason it does not 
cause more lockjaw. Then, also, these cases are taken to 
the physician, while the supposedly insignificant wounds 
made by blank cartridges are neglected. This year 
1,614 accidents, including 7 deaths and 9 cases of lock- 
jaw, were due to the giant firecracker. 

Firearms caused 341 accidents, including 17 killed 
and 4 cases of lockjaw. The percentage of deaths was 
6.1. Of the total number thus injured, 133 were struck 
by stray bullets from the reckless shooting of firearms 
by others and 5 deaths resulted. Toy cannons caused 
437 injuries, including 7 killed and one case of tetanus. 

TOTALS IN CHIEF CITIES 

Table 7 shows the number reported killed and injured 
in the largest cities during the past three years. The 
population figures were taken from the U. S. Census 



21 

Bureau's estimate of 1906. This table -o-ill be of special 
interest from year to year, since it will show the results 
of the adoption and enforcement of ordinances prohibit- 
ing or restricting the use of fireworks. Philadelphia had 
9 deaths this year, the largest number reported for any 
one city, 'New York had 7 deaths, Boston, Pittsburg and 
Lawrence,, Mass., each had 5, while 4 each were reported 
for St. Louis, Kansas City, Mo., and Camden, K. J. 

Of non-fatal accidents this year, New York leads with 
559, followed by Philadelphia with 508, Boston with 
167, St. Louis with 163, Newark with 150, and Chicago 
with lis. 

RESULTS OF EESTEICTIVE LEGISLATION 

For several years Baltimore has practically prohibited 
all forms of fireworks, and the small number of casual- 

TABLE S. — Cases of Tetaxds from Other Causes 

1908. 1909. 190S. 1909. 

Alabama . . Nevada 

Arizona . . New Hampshire 

Arkansas 2 . . New Jersey 7 S 

California 4 4 New Mexico 1 

Colorado 3 .. New York IT 12 

Connecticut 2 2 North Carolina .. . . 1 

Delaware 2 1 North Dakota 1 

Dist. of Columbia Ohio 23 13 

Florida 2 . . Oklahoma 

Georgia 1 Oregon 1 

Idaho . . Pennsylvania 21 21 

Illinois 17 18 Rhode Island 1 

Indiana 6 4 South Carolina 

Iowa 2 7 South Dakota 2 2 

Kansas 4 . . Tennessee 3 

Kentucky 5 5 Texas 4 1 

Louisiana 1 . . Utah 



Maine . . Vermont 

Maryland 3 . . Virginia 4 1 

Massachusetts .... 3 5 Washington 2 

Michigan 4 .5 West Virginia 1 

Minnesota 4 2 Wisconsin 5 4 

Mississippi . . Wyoming 

Missouri 12 5 • 

Montana Total 166 128 

Nebraska 3 States reporting cases. 29 25 

ties shown in Table 7 are the result. In fact, it has been 
stated that, even of the few accidents reported, most 
came from suburbs and outlying districts which were 
not directly under the city ordinances. 

Immediately following last year's celebration, when 
12 persons were killed by fireworks, Cleveland passed a 
prohibitive ordinance, in spite of the protests of fire- 



23 

works dealers. The wisdojn of that legislation is shown 
by the fact that no deaths were reported this year and 
only four minor injuries. 

Washington, our national capital, has set a splendid 
example by enforcing a prohibitory ordinance, with the 
result that this year not a single accident was reported. 

Instead of prohibiting all fireworks, Chicago passed a 
restrictive ordinance limiting the sale to fireworks to a 
few days preceeding Jnly 5 and limited the size of fire- 
crackers. The use of blank cartridge pistols was strictly 
forbidden. Comparatively few licenses to sell fireworks 
were issued, and, according to reports, the ordinance was 
well enforced. No deaths were reported this year as com- 
pared with 12 last year and 16 in 1907. The number of 
injuries still remains high, although it is a splendid 
showing compared with Philadelphia, New York and 
other cities, where very little, if any, restrictive efforts 
were made. Eestrictive ordinances were reported for 
other cities, but no such marked results were apparent. 

WHERE THE RESPONSIBILITY RESTS 

The responsibility for the vast majority of deaths and 
injuries clearly rests with city governments, and this 
annual carnage could doubtless be prevented" without ex- 
treme difiiculty. Prohibitory ordinances are most effec- 
tive and permanent, as shown by the results in Balti- 
more, Washington, San Francisco and Cleveland, and 
even restrictive ordinances, if strictly enforced, are 
rather effective, as shown by the results in Toledo, Chi- 
cago and other cities. But the enforcement of restrictive 
measures is more difficult and requires more constant 
vigilance on the part of the police. By the sound, it is 
difficult to know whether an explosion is due to a fire- 
cracker 3 inches long or to one 5 inches long, or whether 
it is due to some other forbidden form of fireworks. 
Under the prohibitory ordinance any explosion would be 
recognized at once as a violation of the law. Again, the 
smaller sized firecrackers which have been considered so 
harmless caused the clothing to catch fire in many of the 
37 instances where persons, mostly girls and young chil- 
dren, were burned to death. Even the 'Tiarmless" spark- 
ler caused three of these deaths, which were far more 
agonizing than if caused by gunshot wounds. 

The police commissioner of one of our large eastern 
cities is reported to have openly declared himself in 



23 

sympath}^ with the noise, the tumult and the shooting of 
firecrackers in the celebration of the Fourth of July, 
When the results of the celebration in that city were 
known, it was found that 5 lives had been destroyed and 
167 persons were injured, some of whom had eyes blown 
out, hands, fingers and ears torn off, or were otherwise 
marred for life. Of the 5 who were killed, 2 were shot 
down and 3 became human torches, burned in order 
that the people in that city might "wann up and let the 
world know they were alive !" 

With what relief, therefore, we turn to another but 
somewhat smaller eastern city, Springfield, Mass., which 
has set a glorious example in the proper celebration of 
our national birthday and has taken advantage of Amer- 
ica's greatest opportunity to develop true patriotism and 
to bring closer together the various nationalities which 
make up so large a portion of its population. The 
Springfield celebration, which meanwhile cost the com- 
mittee only $3,500 in contributions, has already been so 
well described^ that detailed mention is unnecessary. 

ANNUAL PEEPARATION FOR CASUALTIES 

Thousands of dollars are being spent each year in 
preparation for the casualties of July 4. So exten- 
sive has become this preparation that, as some one has 
pointedly remarked, it resembles the preparation for 
a great battle. How much more enjoyment would result 
as well as uplift and profit if the same energy were ex- 
pended in preparation for more modern methods of 
celebration ! 

RADICAL ACTION NEEDED 

Our annual sacrifice in the celebration of the Fourth 
may be compared to the facts related about the Minotaur 
of old to whom the Greeks were required to sacrifiee 
periodically large numbers of the fair youths and maid- 
ens of Athens. America suffers by the comparison, how- 
ever, since our sacrifice is annual, whereas that of the 
Athenians was only once in nine years ! Eadical meas- 
ures were used then when Theseus slew the Minotaur. 
Eadical measures are needed now and the barbarous 
Fourth should go. The sentiment favoring the enlight- 
ened celebration is rapidly on the increase, but hood- 
lums require more than coaxing — they must be handled 

1. Atlantic Monthly, June, 1909. 



24 

b}' the police. More restrictions were placed on the use 
of fireworks this year than ever before. The celebration 
in many cities was limited to the one day and the sale 
of fireworks was limited to 2 or 3 days. Many forms of 
fireworks were prohibited in many cities and zones of 
quiet were provided for hospitals. And results were ob- 
tained, since from all parts of the country come reports 
that there was never a more quiet and orderly celebra- 
tion. Although the deaths and injuries are as many as 
ever, there is nevertheless much to encourage those who 
are working for truly patriotic methods of celebrating 
our national independence. They should persevere in 
their efforts. 



PEESS OPmiONS EEGAEDING THE FOUETH 
OP JULY CELEBEATION 

x^ever has public sentiment been so thoroughly 
aroused regarding the antiquated and death-dealing 
methods of celebrating Independence Day than at the 
present time, judging from the flood of newspaper clip- 
pings which continue to pour into the office commenting 
on the statistics of deaths and injuries from this j^ear's 
celebration, published in The Journal a few weeks ago. 
Among these comments are many able editorials which 
we should like to publish entire if space permitted. The 
following extracts, however, show how strong has be- 
come the sentiment favorable to any measures which 
would effectively suppress all dangerous and noisy meth- 
ods of celebration. The reasons showing that now is the 
time Avhen cities should pass ordinances prohibiting the 
use of fireworks are clearly set forth in the following 
from the New York Tribune: 

There remains to be made, with all possible earnestness, the 
suggestion that now, right away, is the time for action if the 
good example of those three cities is to be extended next year 
and if the United States is to be rescued from what has be- 
come a, grave national reproach and an impeachment of our 
humanity and common sense. It would be futile paltering to 
wait until a few days before next Fourth of July and then try 
to stop the mischief. The only rational course is to enact 
ordinances or state laws at the earliest possible date, as far as 
possible in advance of the need of their application, so that 
makers of and dealers in explosives will have fair warning and 
they and the public will be prepared for a Fourth of July 
without the usual murderous racket. The publication of such 



25 

statistics as those Avhich we have quoted should mark the 
signing of the death warrant of the toy pistol and all its 
death-dealing kin. 

So widespread and emphatic has become this demand 
for the suppression of dangerous and antiquated meth- 
ods of celebration that cit}^ councils may be assured of 
strong support in the adoption of rigidly restrictive or 
prohibitory ordinances, and now is the time when action 
should be taken. Strike while the iron is hot. 

The Newark (N. J.) News not only gives us an encour- 
aging report regarding Trenton, IST. J., and urges New- 
ark to adopt a similar ordinance, but also reports an- 
other death due to the supposedly harmless "sparker,'' 
the description of which, however, is mild compared 
with the reports of the awful deaths due to lockjaw 
caused in this year's celebration. The comment is as 
follows (italics ours) : 

Trenton has enrolled itself in the list of cities which loill 
henceforth enjoy a safe and sane Fourth of July. Its council 
has adopted the ordinance, introduced at the first meeting 
after the recent Independence Day celebration, prohibiting the 
sale or use of toy cannons, toy pistols, firecrackers and fire- 
works of all kinds, except by persons to whom the Mayor 
grants special permits, upon occasions of public celebrations 
and exhibitions. That Trenton's mayor will approve of the 
ordinance there is no reason to doubt. 

The last victim to die of injuries received at the recent In- 
dependence Day celebration was Anna Hetzel, a little girl in 
Dover. She was a child of ten years, and while setting off one 
of those vicious things known as a "sparker" her clothing 
caught fire and she was terribly burned before the flames could 
be smothered. She lingered in pain that was at times agon- 
izing, until August 12, when she died. 

The following from the York (Pa.) Gazette is charac- 
teristic of many comments which have been made re- 
garding the present methods of celebration : 

If we are to indulge our savage instincts, at least let us be 
honest about it. Let us revive the old worship of Moloch and 
send the spirits of the children adrift in eternity as an offer- 
ing to this devil. Such action would be consistent at least. 
But this is not the solution of the problem. The freedom 
which was purchased by the blood of Bunker Hill and York- 
town was not shed that soulless murder-mongers of to-day 
might deliver over to death and torment tens of thousands of 
their fellow-beings. This is not freedom but the worst kind 
of anarchy. This is the thing that must be stopped. 



26 

The good results obtained by restrictive ordinances in 
several cities will doubtless lead to similar measures 
being adopted elsewhere, as shown by the following, 
also from the New York Tribune: 

We have referred to the efforts of some places to stop this 
infernal work. Three cities thus made themselves notable. 
Washington had a prohibitory ordinance, and suffered no 
casualties whatever. Cleveland also tried prohibition, and 
had only four slight injuries. Chicago had a merely re- 
strictive law, which reduced the usual number of casualties by 
more than one-half. The example of these three cities affords 
a ray of hope amid the general gloom of the year's record. It 
shows that it is quite feasible to put an end to this yearly 
torture and slaughter in the abused name of patriotism, and 
that it is best done by absolute prohibition of such devices as 
toy pistols and blank cartridges — -which are practically loaded 
with tetanus germs. 

Many of the comments favor the absolute prohibition 
of fireworks in the Fourth of July celebration, as illus- 
trated by the following from the Waterbury (Conn.) 
Republican : 

It would seem that 133 years of this demonstrative, danger- 
ous manner of celebrating the date of the independence of the 
country were sufficient, and if the people will not of their own 
volition substitute therefor a saner way of keeping the an- 
niversary they should be obliged by law to do so. 

From the Knoxville (Tenn.) Sentinel: 

The only safety is absolute prohibition of the use of any 
explosive, however harmless it may seem, except in an official 
celebration managed by experts. It would be better, however, 
to substitute something else for powder and dynamite. Ac- 
cidents will keep on marring the national holiday until other 
forms of celebration are devised. 

Cleveland has a justifiable pride in the effectiveness of 
its prohibitive ordinance. The Cleveland Plain Dealer 
says : 

Undoubtedly the sane Fourth idea is spreading. The Amer- 
ican people has nearly outgrown its habit of teaching patriot- 
ism with gunpowder and dynamite. All that was needed was 
a start in the right direction, and Cleveland went far toward 
making the national start by offering an example of the 
beauty of a noiseless, bloodless Independence Day. 

That there is no longer any reasonable excuse for per- 
mitting deaths and injuries which are wholly unneces- 
sary is emphasized by the following from the Atlanta 
(Ga.) Constitution: 



27 

Holiday use and abuse of fireworks and firearms of the dan- 
gerous sort can and should be eliminated; it can be accom- 
plished without the least unreasonable interference with the 
innocent pleasures of childhood. Protection of the children is 
a duty of municipal government and, in this instance, it can 
be performed without expense or cost. 

Although the control of the sale and use of fireworks 
seems to be chiefly a city function, there are some which 
believe that state legislatures could more effectively solve 
the problem. The Washington (D. C.) Post says: 

What is needed in this connection is country-wide prohibi- 
tion of the dangerous devices that are misused on the national 
birthday in a barbaric display of so-called patriotism. It is 
not enough for cities here and there to put them under the 
ban. State legislatures should adopt the necessary restrictions 
forbidding their manufacture. Only by such means will the 
traffic which has cost the United States many thousands of 
lives be brought under control. 

The Sandusky (Ohio) Journal says: 

Apparently the regulation of Fourth of July celebrations 
cannot be left to municipalities, but should be subject to 
state legislation. In too many cities and towns the belief pre- 
vails that the boys should be permitted to "have their fun," 
and the fact that a hundred or more must suffer an agonizing 
death as a result is overlooked. It is time that the state legis- 
latures take notice of this and put an end to the terrible 
slaughter. 

Of all tlie comments made, the opinion was unani- 
mous that present methods of celebration were barbarous 
and inexcusable, and that efforts toward suppression 
should be continued. It remains to be seen whether the 
effective action taken by Baltimore, AYashington, Cleve- 
land and Chicago will also be taken by other cities or 
whether the aAvful sacrifice of this year shall have been 
in vain. 



LIBRARY OF CONGRESS 



011 801 643 9 



PRICES 

Single copy, postpaid $ .04 

10 copies,, postpaid 35 

50 copies, postpaid 1.50 

100 copies, express collect 2.25 

600 and over, express collect, per 100 2.00 



5M-2-10. 



